Did you ever play with dominoes as a kid? Not the "real way" by matching numbers in linear configurations, but in the FUN and exciting way by setting them up in rows to knock down. I have vivid memories of doing this at the kitchen table with my brother or during indoor recess with classmates in elementary school. You would try to see who could make the longest row or a cool shape like a spiral or zig zag. The big finale would be that moment when you finally tapped the first domino with your finger to watch the whole thing "tick tick tick" down in the most satisfactory way. Everyone would cheer and smile at the conclusion-feel success. However, that isn't always how dominoes go.
At this part of our journey to parenthood, I feel like we are almost playing dominoes with the last domino falling being that of bringing home our baby. The thing is, that row of dominoes doesn't stop at the end of the kitchen table. It seems to extent 9 months long, feeling like it is miles and miles past the horizon. Right now though, we can't even get past the first few falling correctly.
On the day of my egg retrieval, we went to the surgical center bright and early. I wasn't scared about the procedure itself and the physical components. All I was scared of was the end result: egg or no egg. The doctor made it clear before starting that there is only one follicle and that there is a chance it will be empty and to maintain hopes. DOMINO ONE: They retrieved the egg! After I was awake and alert post anesthesia, the doctor came in with the good news and I cried. I was so relieved that we had a chance. It certainly was not anywhere near the amount of "chances" we were hoping for, but I was glad to take it.
Even though the surgery may not have been as invasive or extreme as egg retrievals can be since only one ovary was operated on, I was still in a lot of pain and needed to rest. I napped on and off for the next 24 hours anxiously awaiting the clinic's call with an update. DOMINO TWO: The egg fertilized! Through the process of ICSI (basically injecting the egg with a sperm), the egg was successfully fertilized. To top that, it was already comprised of 4 cells! That meant it was growing and doing what it was supposed to do. This was the best news because it meant out one egg was now our one embryo. We were still in the running.
The embryologists at my clinic do not check on the embryo until day 5 to allow it time to grow. By day 5, they want to see it in the blastocyst stage, also known as "blast." This would mean the embryo was continuing to grow properly and cells are starting to divide and separate into their correct spots. When the nurse called on day 5, she said our embryo was not a blast yet, but it was still showing signs of growth. I got really nervous with this because it wasn't good news, but want exactly bad news either. She said it still had a chance and that we would get an update tomorrow. So not quite DOMINO 3, but it could still happen.
Day 6 blasts are very common and can absolutely lead to healthy pregnancies. Not all embryos are the same and some need a bit more time. Well, our update on day 6 was to tell us ours still was not there. The nurse didn't sound as optimistic as the previous day. She shared that it still showed signs of growing and it was beginning to "compact" (apparently it needs to do this before being a blast- IDK: I am new to all of this!). They said it could still be a blast tomorrow and they'd call with an update.
At this point, I wanted to flick down the 2 dominoes and stomp them into dust. All of my hope evaporated because I knew it just wasn't going to happen. This ONE chance was not going to be our miracle. I sobbed and could not control it. My husband held me like a baby and I felt like I wanted to melt into his arms. What the hell is wrong with me?! Even with all these medications and procedures, I still can't have things work right.
The spiral began and all the questions and Googling got the better of me. Many fertility clinics don't bother checking for day 7 blasts because there is not much research on their success. Some sites said they increase the chances of miscarriage and being aneuploid (genetically abnormal). Perfect! Some sites said it happens with advanced maternal age and low ovarian reserves (less eggs). Awesome! Could this have happened inside of me before? Did this cause my miscarriages? Could this be why I had 6 other failed fertility treatment cycles? It was a rough night to say the least.
Around noon on day 7 I get a call and it wasn't a nurse, but one of the doctors. I knew immediately the news was bad. She said that not only did it not make it to blast, but it stopped progressing altogether. It wasn't my usual doctor, so we couldn't discuss next steps or specifics to my case, but I tried to ask what I could. My main quandary was about why it was slow growing and the possible cause of that. She shared that eggs grow at different rates and if I had more than just one, we'd have likely seen some make it and some be behind. She shared that you could expect around half or so of fertilized eggs to become blasts and since we only had one, we had about a 50/50 shot. Naturally, we fell on the less desirable side of the odds.
While I shed a few more tears, I went more into "numb mode." I had my big outburst of emotions the night before and just didn't have the strength in me to do it again. I wouldn't be able to learn about my plan for what we will try next until next week when my doctor returns from out of the country. You know I love waiting! All I know is it will be a completely different protocol.
So I had my entire summer off, 72 days before having to return back to the classroom for a new school year. I planned as much as you can and prayed for the rest to have this summer be productive fertility wise. I may not be able to put the dominos up myself, but I had the space clear with my big box of metaphorical dominoes ready to go. All focus could be on this task alone. My body had other plans though and now I'll be starting all over, conducting another high stakes and high risk science experiment on my body WHILE starting a new school year with new kids, new curriculum, and chaos. I just hope my row of dominoes gets a chance to be built, extending for miles, to the point where they will all fall in perfect time so I get to cheer at the finale and hold a baby in my arms. I'm tired of instead crying with empty arms.
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